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Old 05-04-2014
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Question Cauda Equina Sx vs Conus Medullaris Sx

Hi could someone clarify the DIFFERENTIAL between both?

uworld and highyield neuroanatomy seem to contradict each other


DO BOTH have saddle anesthesia???
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Last edited by drpisho; 05-04-2014 at 11:03 AM.
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Old 05-05-2014
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This is how I understand it.

Cauda equina syndrome:

1. unilateral problem, not bilateral, because it's a lateral lesion eg. tumor on lateral side
2. gradual onset
3. severe unilateral root pain
4. unilateral muscle atrophy, DTR -ve on affected side
5. unilateral saddle anesthesia
6. sphincter and sexual function is normal because it's a unilateral problem (need both sides to be affected to get sphincter and sexual problems)

Conus Medullaris syndrome:

1. bilateral problem
2. sudden onset
3. bilateral pain (but not severe)
4. no muscle changes (lower limbs normal), DTR normal
5. bilateral saddle anesthesia
6. sphincter and sexual function impaired (because it's a bilateral problem)
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  #3  
Old 05-05-2014
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Cool

Quote:
Originally Posted by sunam View Post
This is how I understand it.

Cauda equina syndrome:

1. unilateral problem, not bilateral, because it's a lateral lesion eg. tumor on lateral side
2. gradual onset
3. severe unilateral root pain
4. unilateral muscle atrophy, DTR -ve on affected side
5. unilateral saddle anesthesia
6. sphincter and sexual function is normal because it's a unilateral problem (need both sides to be affected to get sphincter and sexual problems)

Conus Medullaris syndrome:

1. bilateral problem
2. sudden onset
3. bilateral pain (but not severe)
4. no muscle changes (lower limbs normal), DTR normal
5. bilateral saddle anesthesia
6. sphincter and sexual function impaired (because it's a bilateral problem)
makes total sense, nutshell is that conus medullaris is MORE severe, shows IMPOTENCE, and more likely BILATERAL affection,
thank you, i was getting confused, trying to keep it simple for doing differential thanks for taking your time and replying.

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